Diabetes mellitus is more than just a disorder of metabolism now; it stands as the second most frequent cause of preventable blindness in the world. In parallel with the rising prevalence of diabetes all over the world, most importantly in developing countries like India, diabetes-induced blindness is also increasing at an alarming pace. This becomes a major concern since in majority of cases the blindness can be prevented by means of early diagnosis and intervention.
Understanding diabetic eye disease
According to Dr Aravind Badiger, Technical Director, BDR Pharmaceuticals, “The leading cause of blindness in diabetics is diabetic retinopathy. Prolonged periods of high blood sugar can damage the small blood vessels of the retina. These may begin to leak, swell or close after some time, impairing vision; more severely one may see growth of abnormal new blood vessels. Similarly, eye conditions such as diabetic macular oedema (DME), cataracts, and glaucoma are more prevalent among diabetics.”
Why are cases increasing?
The doctor explained that sedentary lifestyle, wrong eating habits, obesity and hereditary factors are responsible for early onset of diabetes. When an individual lives for a longer time with diabetes that is uncontrolled then risk of complications like retinopathy increase.
Lack of glycaemic control is the other major risk factor. Some people go undiagnosed for many years and some people are diagnosed but not well controlled, allowing hyperglycaemia to occur and blood vessel damage to progress rapidly and often without any obvious symptoms.
Low awareness of the disease and late presentation is another contributing factors. Diabetic retinopathy is silent in its early stages, and patients only present themselves to medical facilities once vision has already been compromised. Furthermore, lack of easy access to regular eye examinations can lead to delayed presentation of the disease in the underprivileged sectors.
The role of coexisting risk factors
“High blood glucose adds to the risk factor for diabetic eye. Pregnancy can also lead to progression of retinopathy in women with diabetes and thus it needs a more frequent monitoring during pregnancy,” the doctor added.
Early detection
Early and regular screening of eyes is a vital component of diabetes blindness prevention. An annual dilated eye examination can identify diabetic retinopathy before any symptoms develop and the condition can be treated at its earliest stages with better glycaemic control, laser photocoagulation or intravitreal medication, slowing or ceasing progression of the disease. Patients should be informed that “good eyesight does not equal healthy eyes”.
Management and lifestyle interventions
As said prevention is better than cure; it is important to control BP, blood sugars and lipids at the target levels. This has been shown to reduce risk of eye complications.
A balance diet, exercise and saying no to smoking, and adherence to prescribed medications are essential components of care. Advances in eye treatment such as anti-VGEF, micro-invasive surgery which have given excellent results all help and increase prognosis but prevention is always better than cure.
Turning awareness into action
The trend of increasing numbers of people going blind due to diabetes illustrates wider issues with levels of awareness, early detection and the long-term management of disease. Although the prevalence is increasing, the illness is still very preventable with effective and early management. With the correct information and motivation, plus effective diabetes care and screenings, this may be reversed.
Disclaimer: Dear readers, this article provides general information and advice only. It is not at all professional medical advice. Therefore, always consult your doctor or a healthcare specialist for more information.
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